Recently, the theory of "cancer stem cells" (CSC) was proposed to explain tumor heterogeneity and carcinogenesis processes. According to this theory, tumors may be caused by an abnormal organogenesis caused by CSC, which derives from mutations of "normal" adult stem cells. Mutations into CSC are transmitted to each daughter cell; transmission can stop at any of several points before full maturity. Whatever their origin, these cells possess several properties of normal stem cells, including self-renewal, unlimited proliferation potential to produce heterogeneous lineages of cancer cells including tumor growth and metastasis, and high resistance to conventional chemotherapy. These characteristics make them possible causes of disease relapse and metastasis. The existence of CSC was frst demonstrated in acute myeloid leukemia and more recently in other leukemias, glioblastoma, melanoma and solid tumors of epithelial origin. In this work, our aim is to demonstrate the possible relationship between stem cells and lung cancer.

Recientemente, para explicar la heterogeneidad del tumor y los procesos de carcinogénesis, se ha propuesto la teoría de la "célula madre del cáncer" (CSC). Según esta teoría, el tumor puede ser originado por un anormal organogénesis ocasionado en la CSC, que deriva de las mutaciones de la célula madre adulta "normal". Las mutaciones en la CSC se transmiten a cada célula hija la cual puede detenerse en cualquiera de los numerosos puntos antes de la maduración completa. Bien, independientemente de su origen, estas células poseen varias propiedades de las células madre normales, incluyendo autorenovación, un potencial de proliferación ilimitada para producir los linajes heterogéneos de células del cáncer que componen el crecimiento del tumor y las metástasis, además de que son altamente resistentes a la quimioterapia convencional. Estas características son las que las hacen como posibles causas de recurrencia de la enfermedad y la metástasis. La existencia de CSC se demostró por primera vez en la leucemia aguda mieloide y más recientemente en otras leucemias, glioblastoma, melanoma y tumores sólidos de origen epitelial. En esta revisión estudiaremos las células madre de pulmón y su posible relación con el cáncer de pulmón.

Adult stem/progenitor cells are found in different human tissues. An in vitro cell culture is needed for their isolation or for their expansion when they are not available in a sufficient quantity to regenerate damaged organs and tissues. The level of complexity of these new technologies requires adequate facilities, qualified personnel with experience in cell culture techniques, assessment of quality and clear protocols for cell production. The rules for the implementation of cell therapy centers involve national and international standards of good manufacturing practices. However, such standards are not uniform, reflecting the diversity of technical and scientific development. Here standards from the United States, the European Union and Brazil are analyzed. Moreover, practical solutions encountered for the implementation of a cell therapy center appropriate for the preparation and supply of cultured cells for clinical studies are described. Development stages involved the planning and preparation of the project, the construction of the facility, standardization of laboratory procedures and development of systems to prevent cross contamination. Combining the theoretical knowledge of research centers involved in the study of cells with the practical experience of blood therapy services that manage structures for cell transplantation is presented as the best potential for synergy to meet the demands to implement cell therapy centers.

Células-tronco são células indiferenciadas. Como tal, apresentam uma série de características que as tornam candidatas à utilização terapêutica. As principais características das células-tronco são a capacidade de autorrenovação e de se diferenciarem em diversos tipos celulares. Desta forma, acredita-se que células-tronco presentes nos diferentes tecidos tenham papel regenerativo quando estes sofrem uma lesão ou injúria. Entre os tecidos conhecidos por apresentarem células-tronco após a vida pós-natal, a medula óssea foi a mais estudada, por muitos anos, como fonte tanto de células-tronco hematopoéticas quanto de células-tronco mesenquimais, também denominadas de células mesenquimais estromais da medula óssea ou células estromais mesenquimais multipotentes. Estas células são um grupo de células clonogênicas, presentes no estroma da medula óssea, que, quando submetidas a diferentes estímulos apropriados, são capazes de se diferenciarem em várias linhagens de células, como a osteogênica, a condrogênica e a adipogênica e, possivelmente, em outros tipos celulares não mesodérmicos, como células neurais ou hepatócitos. Nesta revisão, as principais características das células-tronco mesenquimais serão abordadas, incluindo os marcadores moleculares e de membrana, as características de divisão e de diferenciação, a heterogeneidade e as aplicações clínicas potenciais.

Stem cells are undifferentiated cells. They show various characteristics that make them suitable for clinical applications. The main stem cell characteristics are their capacity of autorenewal and of differentiation into different cell lines so it is quite possible that stem cells in different tissues exhibit a regenerative role when these tissues are injured. Bone marrow is the best studied tissue as a source of hematopoietic stem cells as well as mesenchymal stem cells (also known as mesenchymal stromal cells or mesenchymal stromal multipotent cells); clonogenic cells in the bone marrow stroma. They are able to differentiate under specific stimuli in several cell lines including osteogenic, chondrogenic and adipogenic cells, and probably in other nonmesodermic cell lines such as neural cells or hepatocytes. Here the main characteristics of mesenchymal stem cells will be discussed, including the molecular and membrane markers, the division and differentiation properties, the heterogeneity, and the potential clinical applications.

Desde o primeiro isolamento e cultivo de células-tronco embrionárias humanas, há mais de 10 anos, seu uso na pesquisa e terapia foi inibida por considerações éticas complexas e pelo risco de transformação maligna destas células indiferenciadas após transplante no paciente. As células-tronco adultas são eticamente aceitas e o risco de transformação maligna é muito baixo. Entretanto, seu potencial de diferenciação e sua capacidade proliferativa são limitados. Cerca de 6 anos atrás, a descoberta de célulastronco no líquido amniótico que expressavam Oct-4, um marcador específico de pluripotencialidade, com alta capacidade de proliferação e diferenciação, iniciou um novo campo promissor na área das células-tronco. Estas células têm potencial de se diferenciar em células dos três folhetos germinativos. Não formam tumores in vivo e não levantam os questionamentos éticos associados com as células-tronco embrionárias humanas. Futuras investigações revelarão se as células-tronco do líquido amniótico realmente irão representar um tipo intermediário com vantagens em relação tanto às células-tronco embrionárias quanto às adultas. Este artigo faz uma revisão acerca destes tópicos e das características biológicas das células-tronco do líquido amniótico.

Since the first successful isolation and cultivation of human embryonic stem cells about 10 years ago, their use for research and therapy has been constrained by complex ethical considerations as well as by the risk of development of malignancies of undifferentiated embryonic stem cells after transplantation into the patient. Adult stem cells are ethically acceptable and the risk of tumor development is low. However, their differentiation potential and proliferative capacity are limited. About 6 years ago, the discovery of Oct-4 expressing amniotic fluid stem cells, a specific marker of pluripotency, with a high proliferative capacity, and multilineage differentiation potential, initiated a promising field of research. These cells, indeed, have the potential to differentiate into cells of all three embryonic germ layers. They do not form tumors in vivo and do not raise ethical concerns. Further investigation will reveal whether these cells really are an intermediate cell type with advantages over both embryonic and adult stem cells. This article reviews the biological characteristics of amniotic fluid stem cells.